Halve-dose Magnesium Sulphate Regimen Compared to the Pritchard Regimen in the Management of Pre-eclampsia and Eclampsia: A Prospective Single Blind Randomized Study in a Private Hospital

Olusanya Abiodun, Oluwadara Ola, Omobolaji Oguntoyinbo

Abstract


Hypertensive diseases in pregnancy constitute a major concern and it is a major cause of maternal and perinatal morbidity and mortality worldwide and especially in the resource-challenged countries. Regimens for administration of magnesium sulphate have evolved over the years with different regimens being advocated.   Objective: to compare the effectiveness of halve-dose regimen of magnesium sulphate therapy with standard Pritchard regimen in the management of patients with either pre-eclampsia or eclampsia. Result: out of 1,699 deliveries recorded during the period of study 74 patients that met the inclusion criteria were recruited for this study 75.7% presented primarily with pre-eclampsia while 24.3% presented with eclampsia primarily. Booked patients were 52.7% while 47.3% were unbooked. There were two arms of this study; the standard Pritchard and the half-dose regimen arms. The standard Pritchard regimen arm had 36 subjects while the half-dose regimen had 38 subjects respectively. The same number of subjects in the two arms progressed from pre-eclampsia to eclampsia. There were more patients with recurrent convulsion in the standard Pritchard regimen arm compared to the half-dose regimen though this was not statistically significant.

Case fatality was 1.35% and it was due to HELLP syndrome. Neonatal admission and mortality were not significantly different between the two arms of the study. Patients’ satisfaction was generally more in the half-dose regimen arm. Conclusion: from this study it is shown that giving half the dose of the standard Pritchard regimen is as effective as the standard Pritchard regimen itself. The import of this is that the risk of complications arising from magnesium sulphate is reduced, cost of treatment is also less, and overall general patient satisfaction is encouraging.


Keywords


half-dose regimen; Pritchard regimen; eclampsia; pre-eclampsia; magnesium sulphate.

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